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NPI Code Detail

MEDICARE: MORIBITO RX LLC

MEDICARE: MORIBITO RX LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy28RS00426400NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13130680OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number : 1932181732
Entity Type Code : Organization
Provider Name (Legal Business Name) : MORIBITO RX LLC
Provider Business Mailing Address
First Line : 21 N 20TH ST
Second Line :
City : KENILWORTH
State : NJ
Zip : 07033-1613
Country : US
Telephone Number : 908-709-1414
Fax Number : 908-709-1543
Provider Business Practice Location Address
First Line : 21 N 20TH ST
Second Line :
City : KENILWORTH
State : NJ
Zip : 07033-1613
Country : US
Telephone Number : 908-709-1414
Fax Number : 908-709-1543
Authorized Official
Title or Position : OWNER
Name : RAMY SADEK
Credential :
Telephone Number : 908-709-1414
Provider Enumeration Date : 11/17/2005
Last Update Date : 05/08/2018

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Directions to “MORIBITO RX LLC ” Practice Location

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